6/14/19, 11:13 AMMeniscus Tears - OrthoInfo - AAOS

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DISEASES & CONDITIONS

Meniscus TearsMeniscus tears are among the most common knee injuries. Athletes, particularly those who play

contact sports, are at risk for meniscus tears. However, anyone at any age can tear a meniscus.

When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus.

AnatomyThree bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap

(patella).

Two wedge-shaped pieces of cartilage act as "shock absorbers" between your thighbone and

shinbone. These are called meniscus. They are tough and rubbery to help cushion the joint and

keep it stable.

Normal anatomy of the knee. The menisci are two rubbery disks

that helps cushion the knee joint.

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Description

Cause

Menisci tear in different ways. Tears are noted by how they look, as well as where the tear

occurs in the meniscus. Common tears include bucket handle, flap, and radial.

Sports-related meniscus tears often occur along with other knee injuries, such as anterior

cruciate ligament tears.

Types of meniscus

tears:

(Left) Bucket handle

tear. (Right) Flap tear.

(Left) Radial tear.

(Right) Degenerative

tear.

Sudden meniscus tears often happen during sports. Players may squat and twist the knee,

causing a tear. Direct contact, like a tackle, is sometimes involved.

Older people are more likely to have degenerative meniscus tears. Cartilage weakens and wears

thin over time. Aged, worn tissue is more prone to tears. Just an awkward twist when getting up

from a chair may be enough to cause a tear, if the menisci have weakened with age.

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Symptoms

Doctor Examination

You might feel a "pop" when you tear a meniscus. Most people can still walk on their injured

knee. Many athletes keep playing with a tear. Over 2 to 3 days, your knee will gradually become

more stiff and swollen.

The most common symptoms of meniscus tear are:

Pain

Stiffness and swelling

Catching or locking of your knee

The sensation of your knee "giving way"

You are not able to move your knee through its full range of motion

Without treatment, a piece of meniscus may come loose and drift into the joint. This can cause

your knee to slip, pop, or lock.

Physical Examination and Patient History

After discussing your symptoms and medical history, your doctor will examine your knee. He or

she will check for tenderness along the joint line where the meniscus sits. This often signals a

tear.

One of the main tests for meniscus tears is the McMurray test. Your doctor will bend your knee,

then straighten and rotate it. This puts tension on a torn meniscus. If you have a meniscus tear,

this movement will cause a clicking sound. Your knee will click each time your doctor does the

test.

Imaging Tests

Because other knee problems cause similar symptoms, your doctor may order imaging tests to

help confirm the diagnosis.

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Treatment

X-rays. Although x-rays do not show meniscus tears, they may show other causes of knee pain,

such as osteoarthritis.

Magnetic resonance imaging (MRI). This study can create better images of the soft tissues of

your knee joint, like a meniscus.

How your orthopaedic surgeon treats your tear will depend on the type of tear you have, its size,

and location.

The outside one-third of the meniscus has a rich blood supply. A tear in this "red" zone may heal

on its own, or can often be repaired with surgery. A longitudinal tear is an example of this kind

of tear.

In contrast, the inner two-thirds of the meniscus lacks a blood supply. Without nutrients from

blood, tears in this "white" zone cannot heal. These complex tears are often in thin, worn

cartilage. Because the pieces cannot grow back together, tears in this zone are usually surgically

trimmed away.

Along with the type of tear you have, your age, activity level, and any related injuries will factor

into your treatment plan.

Nonsurgical Treatment

If your tear is small and on the outer edge of the meniscus, it may not require surgical repair. As

long as your symptoms do not persist and your knee is stable, nonsurgical treatment may be all

you need.

RICE. The RICE protocol is effective for most sports-related injuries. RICE stands for Rest, Ice,

Compression, and Elevation.

Rest. Take a break from the activity that caused the injury. Your doctor may recommend

that you use crutches to avoid putting weight on your leg.

Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to

the skin.

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Compression. To prevent additional swelling and blood loss, wear an elastic compression

bandage.

Elevation. To reduce swelling, recline when you rest, and put your leg up higher than your

heart.

Non-steroidal anti-inflammatory medicines. Drugs like aspirin and ibuprofen reduce pain and

swelling.

Surgical Treatment

If your symptoms persist with nonsurgical treatment, your doctor may suggest arthroscopic

surgery.

Procedure. Knee arthroscopy is one of the most commonly performed surgical procedures. In it,

a miniature camera is inserted through a small incision (portal). This provides a clear view of the

inside of the knee. Your orthopaedic surgeon inserts miniature surgical instruments through

other portals to trim or repair the tear.

Partial meniscectomy. In this procedure, the damaged meniscus tissue is trimmed away.

Meniscus repair. Some meniscus tears can be repaired by suturing (stitching) the torn

pieces together. Whether a tear can be successfully treated with repair depends upon the

type of tear, as well as the overall condition of the injured meniscus. Because the meniscus

must heal back together, recovery time for a repair is much longer than from a

meniscectomy.

Illustration and photo show a camera and instruments inserted through portals in a knee.

6/14/19, 11:13 AMMeniscus Tears - OrthoInfo - AAOS

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Last ReviewedMarch 2014

Contributed and/or Updated byRick Wilkerson, DO

Peer-Reviewed byStuart J. Fischer, MD

Recovery

Once the initial healing is complete, your doctor will prescribe rehabilitation exercises. Regular

exercise to restore your knee mobility and strength is necessary. You will start with exercises to

improve your range of motion. Strengthening exercises will gradually be added to your

rehabilitation plan.

For the most part, rehabilitation can be carried out at home, although your doctor may

recommend physical therapy. Rehabilitation time for a meniscus repair is about 3 months. A

meniscectomy requires less time for healing — approximately 3 to 4 weeks.

(Left): Close-up of

partial

meniscectomy.

(Right): A torn

meniscus repaired

with sutures.

Meniscus tears are extremely common knee injuries. With proper diagnosis, treatment, and

rehabilitation, patients often return to their pre-injury abilities.

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AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This

information is provided as an educational service and is not intended to serve as medical advice. Anyone

seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate

one in your area through the AAOS Find an Orthopaedist program on this website.